Justina Pelletier: The Case Continues

Philip Hickey, PhD

April 4, 2014

On March 25, Joseph Johnston, Juvenile Court Justice in Boston, Massachusetts, issued a disposition order in the case: Care and protection of Justina Pelletier.  The background to the case is well-known.  Justina is 15 years old.

Judge Johnston did not return Justina to the care of her parents, but instead granted permanent custody to the Massachusetts Department of Children and Families (DCF), with a right to review in June.

In paragraph 4, the disposition order states:

“At trial there was extensive psychiatric and medical testimony.  Voluminous psychiatric and medical records were entered in evidence.  Based on credible psychiatric and medical evidence this court has found that Justina suffers from a persistent and severe Somatic Symptom Disorder.  On December 20, 2013, this court found the MA DCF sustained its burden by clear and convincing evidence that Justina Pelletier is a child in need of care and protection pursuant to G.L c. 119, §§ 24-26 due to the conduct and inability of her parents, Linda Pelletier and Lou Pelletier, to provide for Justina’s necessary and proper physical, mental, and emotional development.”

This is the substantial finding of the court, and it is noteworthy that there is no mention of the mitochondrial disease which had been Justina’s earlier diagnosis and for which she had been receiving treatment at Tufts Medical Center, Boston. 

The disposition order is somewhat terse and sparing in its tone, but reading between the lines, it seems clear that the court has determined that Justina either does not have mitochondrial disease or that, even if she does have mitochondrial disease, her concern about this matter is inappropriate and excessive.  There is also the suggestion that her parents, Linda and Lou Pelletier, have contributed to Justina’s preoccupations in this regard, and that for this reason, Justina needs to be protected from them.  As in all cases of this kind, a great deal of the information is kept confidential.  So we are inevitably working with incomplete information.

Obviously there are many issues that might be raised, and these are being addressed by others, but I would like to focus here on the “diagnosis” of somatic symptom disorder.

DSM-5 describes somatic symptom disorder as:  “…distressing somatic symptoms plus abnormal thoughts, feelings, and behaviors in response to these symptoms.”  A “diagnosis” of somatic symptom disorder can be assigned even if the person really does have an actual illness, provided that the person’s response to the symptoms of the illness is excessively distressing and disruptive.

Here are the actual diagnostic criteria as set out on page 311 of DSM-5:

Somatic Symptom Disorder 300.82 Diagnostic Criteria

A.  One or more somatic symptoms that are distressing or result in significant disruption of daily life.
B.  Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns as manifested by at least one of the following:

1.  Disproportionate and persistent thoughts about the seriousness of one’s symptoms.
2.  Persistently high level of anxiety about health or symptoms.
3.  Excessive time and energy devoted to these symptoms or health concerns.

C.  Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically more than 6 months).

Specify if:

With predominant pain (previously pain disorder): This specifier is for individuals whose somatic symptoms predominantly involve pain.

Specify if:

Persistent:  A persistent course is characterized by severe symptoms, marked impairment, and long duration (more than 6 months).

Specify current severity:

Mild:  Only one of the symptoms specified in Criterion B is fulfilled.
Moderate:  Two or more of the symptoms specified in Criterion B are fulfilled.
Severe:  Two or more of the symptoms specified in Criterion B are fulfilled, plus there are multiple somatic complaints (or one very severe somatic symptom).

Criterion A

DSM-5 (p 830) defines a symptom as:  “A subjective manifestation of a pathological condition.  Symptoms are reported by the affected individual rather than observed by the examiner.  Compare with SIGN.”  On page 829 they define a sign as:  “An objective manifestation of a pathological condition.  Signs are observed by the examiner rather than reported by the affected individual.  Compare with SYMPTOM.”  This kind of terminology has become standard in general medicine.  A symptom is something reported by the patient (e.g. abdominal pain); a sign is something observed by the examiner (e.g. distended abdomen).  Symptoms and signs are the twin pillars of medical diagnosis.

“Somatic” means bodily or physical, as opposed to mental.

So criterion A requires that the individual reports at least one physical symptom, and that this symptom is distressing and results in significant disruption of daily life.  Distress and significant disruption are vague concepts, the assessment of which is clearly dependent on the psychiatrist’s subjective judgment.

Criterion B

Here again, we have a great deal of subjectivity.  Words like “excessive” and “disproportionate” are open to individual interpretation, and there are no objective standards by which the accuracy of the diagnostic decision can be assessed.

Ultimately, a person will meet the requirements of criteria A and B if, and because, a psychiatrist says so.  There is no objective reality against which the psychiatrist’s assessment can be checked.  The psychiatrist’s subjective assessment is the only test for a “diagnosis” of somatic symptom disorder.

So when a psychiatrist says that a person “suffers from somatic symptom disorder,” all that this means is:  “In my opinion this individual is excessively preoccupied with physical symptoms and that, also in my opinion, this preoccupation is causing significant disruption in his/her life.”

The APA, by including this “diagnosis” in their diagnostic manual, assigning it a name and number, and listing the diagnostic criteria, create the impression that this is a real illness, and distract attention from the central fact:  that the only reality here is a psychiatrist’s opinion.

The only justification for the assertion that Justina Pelletier “suffers from a persistent and severe Somatic Symptom Disorder” is a psychiatrist’s subjective opinion.  In fact, the statement “Justina suffers from somatic symptom disorder” means:  “A psychiatrist believes that Justina’s concern about her symptoms is excessive.”  These two statements are absolutely equivalent.  The first statement, despite its appearance of objectivity, contains no additional substance over the second.

Conflicts of Interest

This deception is the foundation of modern psychiatry.  But it doesn’t just occur at the point of individual assessment.  It also applies to the invention of these illnesses in the first place.  Somatic symptom disorder, like all psychiatric diagnoses, is considered to be an illness because the APA say so.  And individuals are considered to have a particular psychiatric “illness” because an individual psychiatrist says so.  It’s all based on subjective opinion.  And subjective opinion is notoriously unreliable.

But it is particularly unreliable when there are conflicts of interest.  The notion that all significant problems of thinking, feeling, and/or behaving are illnesses is central to the APA’s survival.  When the day comes – as it surely will – that it is recognized that these problems are not illnesses, then psychiatry will go the way of astrology and phrenology.  It will cease to exist.  Psychiatry’s foundation is an enormous deception, and in my view psychiatrists know this.  But they are fighting for their very existence.  The conflict of interest isn’t just about money; it’s also a matter of their professional identity.  As a group, they are so invested in the notion of psychiatric illness that they have rendered themselves incapable of honestly and objectively addressing the question:  are these problems really illnesses?

In this context, psychiatrists frequently point out that diagnoses in general medicine sometimes involve a physician’s opinion.  This is true, but misses the point.  When a real doctor says: In my opinion, this person’s diagnosis is X, what he’s saying is that he’s not 100% sure what the actual physical etiology is, but his best assessment at that point in time is X.  In psychiatric “diagnosis” there is no reality against which the “diagnosis” can be checked.  There is nothing but the psychiatrist’s opinion.

At the present time, small numbers of individual psychiatrists are seeing the light, and are courageously struggling with these conceptual issues.  But organized psychiatry in the form of the APA is actually doubling down and fighting harder than ever to prop up the deception that is crumbling like a sandcastle in a flowing tide.

And, of course, there is a huge conflict of interest for individual psychiatrists during their initial evaluations.  The psychiatrist’s bill, whether it’s sent to a private insurance carrier, or Medicare, or other reimbursing entity, depends for its legitimacy on the diagnosis.  Without a diagnosis, the psychiatrist doesn’t get paid!

So the situation is this:  the “diagnosis” is based entirely on the psychiatrist’s subjective opinion; and the psychiatrist’s paycheck depends entirely on the diagnosis.  Not surprisingly, psychiatrists manage to “uncover” a great many diagnoses.  In fact, the psychiatric leadership routinely and confidently claim that at any given time about ¼ of the US population has a mental disorder/illness, and that the lifetime prevalence is a staggering 50%.  They remain blind to the fact that these figures are driven by their own interest-invested need to create more “diagnoses” with progressively lower thresholds, and by their members’ equally self-serving need to assign more “diagnoses” in individual cases.

And this is the background against which Judge Johnston felt confident enough to write:

“Based on credible psychiatric and medical evidence this court has found that Justina suffers from a persistent and severe Somatic Symptom Disorder.”

I truly cannot think of any significant field of human endeavor in which such far-reaching decisions would be made on the basis of such poor evidence.  And bear in mind, Justina’s is by no means an isolated case.

If parents are abusing or neglecting their children – and obviously these things do happen – then some kind of intervention is appropriate.  But interventions of this sort should always be based on clear evidence and with due regard to the rights of the parents and the rights of the child.  But a “diagnosis” of somatic symptom disorder, by its very definition can never reach the standard of clear evidence.  

* * * * *

This article first appeared on Philip Hickey’s
Behaviorism and Mental Health blog.

 

Philip Hickey, PhD

Philip Hickey is a retired psychologist.  He has worked in prisons (UK and US), addiction units, community mental health centers, nursing homes, and in private practice.  He and his wife, Nancy, live in Colorado, and have four grown children.

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52 thoughts on “Justina Pelletier: The Case Continues

  1. Excellent article, Phillip. You’ve laid this out so clearly and rationally.

    “This deception is the foundation of modern psychiatry. But it doesn’t just occur at the point of individual assessment. It also applies to the invention of these illnesses in the first place. Somatic symptom disorder, like all psychiatric diagnoses, is considered to be an illness because the APA say so. And individuals are considered to have a particular psychiatric “illness” because an individual psychiatrist says so. It’s all based on subjective opinion. And subjective opinion is notoriously unreliable.”

    How terribly ironic that these “experts” have successfully substituted their own bogus illness for one that they claim existed only in the minds of the girl, her family, and the doctors who followed her for an extensive period! And how chilling that such chicanery was upheld in a court of law to the point where she has been essentially kidnapped and incarcerated by the state!

    And your analysis confirms and strengthens my conviction that Justina’s case is only the tip of the iceberg, in terms of the terrible hoax being perpetuated in our society at the expense of many unwitting and voiceless victims of our draconian Gulag Psychepelago! Fortunately, the Pelletiers have finally gotten considerable attention and sympathy from both the public and various public officials, owing at least partially to Lou Pelletier’s chutzpah, verbal skills and willingness to defy the “powers that be” on behalf of his daughter. Hopefully, with the help of God (which I believe is often effected through people who are attentive to his Spirit) justice will prevail in this case. What’s really sad is that there are probably many, many more kids and families who are being similarly misled, coerced and torn apart every day by similar but less dramatic circumstances. We really have to rise up and stand against this wolf in sheep’s clothing!

    • For me the most mind-boggling thing is that it’s the family who got the blame for medical neglect while they clearly did nothing wrong. I mean if I take my kid to one doctor and he tells me she had disease A and then on another occasion I take it to another doctor and hear another diagnosis, B, what am I supposed to do? In such case going with either of the opinions puts me in danger of losing right to my child based on medical neglect. It’s Catch-22 (on which all psychiatry is kind of based on). Add to that the facts mentioned in the article (complete subjectivity and unverifiability of the stated diagnosis) and welcome to crazy land. Why has no one asked the opinion of Justina’s other doctors? Or Justina herself – oh, right she’s insane together with her parents. I like how now mental illness is contagious and can spread to family members. Very clever if you have to deal with the family who does not buy the “it’s all in her head” story.

  2. I continue to look for value in psychiatry but the going is tough, and the more I look the less I find. I sense that Lou Pelletier is in a similar place as he describes the helplessness of falling in a rabbit hole. What defense is there when the judge can be bamboozled by the malleable criteria in the DSM and declare a clear winner? Dr. Hickey points out that Justina isn’t an isolated case and that is backed up by the Boston Globe. Few parents would challenge this system even if they could. I’d like to know if this judge ever ruled in favor the parents in a somatoform / medical child abuse case.

    • Juvenile Court judges issue rulings in Medical Child Abuse cases that reflect their discretion in terms of “medical expertise”. It is not within the judge’s authority, by virtue of his own lacking in knowledge of medical diagnosis and treatment, to decide matters pertaining to medical practice itself. Unlike other cases of child maltreatment brought before a juvenile court judge – by DCF, MEDICAL child abuse is handled strictly by the medical community. Obvious conflicts of interest arise from this set up. I suspect this was intentional on the part of child psychiatry. It is consistent with the expectation of having ultimate legal authority that psychiatry owes to a long history of — just that.

      This judge deferred consistently to Dr. Alice Newton as the top medical expert–as she is a board verified pediatric child abuse specialist. Her claim was that Justina’s prior medical and surgical interventions were both harmful and instigated by her parents. She obviously had more than the impressions of “fairly new and inexperienced BCH clinicians” (Boston Globe 12/15-16 2013) to substantiate her claim- though it needs to be emphasized that it is child/adolescent psychiatrists who are initiating medical child abuse cases. It should be equally stressed that specialists like, Dr. Newton, are not pediatric medical specialists and that they work very closely with psychiatric clinicians– when consulting on most cases of suspected child abuse.

      In the December Boston Globe article. Neil Swidey briefly reported that there is growing concern regarding the power of Child Protective Team- pediatric specialists- MDs. Justina’s case clearly leads us to conclude that grave concerns about the potential/probable abuse of this power needs to be addressed immediately.

      It is no small coincidence that the text book on MCA was co-authored by a husband and wife team; a child psychiatrist and a pediatric child abuse expert.

      It is astounding that this book was stamped with the approval of the American Academy of Pediatrics. The combination of MCA and SSD is a green light for psychiatrists to hijack kids with rare diseases from pediatric specialists.

      • Sinead,

        You’re right. The concept of mental illness is deeply embedded in our statutes and legal procedures. Judges have to go along with the fiction that these are real illnesses, even if their personal beliefs might be otherwise. This is why we need to work on so many fronts. Have you seen Michael Cornwall’s April 3 Mad in America article It’s Time For A Stronger Political Ground Game To Compete With NAMI & Company On Forced Treatment?

        Best wishes.

    • To me it feels super fishy. I mean even a half brained judge should at least asked the Tufts doctors for an opinion or appointed an unrelated professional to assess the case. And why in case of the conflicting medical opinion the parents are to blame? I don’t know what kind of personal profit could possibly stand behind such a ruling but it seems to me that you’d have to be really dumb not to take these issues into account.

  3. A terrific article. You are certainly right that no diagnosis of somatic symptom disorder can support the very severe actions of BCH, DCF or the Court in the case of Justina Pelletier. Criteria for somatic symptom disorder are appallingly vague and subjective. Further, there is so much dissent within the psychiatry community about the validity of SSD that it’s hard to imagine any court using it as the basis for actions of any kind.

    I think it’s likely somatic symptom disorder has actually not been grounds for any of the Court’s actions in this case until very recently. “Somatoform disorder” is the term that’s been used exclusively in the media, by the parents, and in the records released by the media up until this ruling. In reality it’s hard to see how this case could have developed if somatoform disorder had not been the core of the matter from the start.

    A patient with somatoform disorder (still in use through current ICD editions) has physical symptoms that have psychiatric causes rather than medical ones, so in using that label BCH would have said very clearly “there’s a difference of opinion between our staff and staff at Tufts on the medical reality of Justina Pelletier’s symptoms – and the parents are guilty of medical child abuse for not recognizing that we’re right and Tufts is wrong” (sic!).

    On the other hand, a patient with somatic symptom disorder has physical symptoms they worry too much about – so using that label would say nothing at all about a difference of opinion between BCH and Tufts on the medical reality of the girl’s symptoms. Moreover, it would say nothing at all to cast suspicion on the parents’ approach to their daughter’s condition.

    If BCH had taken this case to DCF as somatic symptom disorder a custody challenge could not have ensued, and if DCF had taken it to the Court with that label the whole thing would have ended there. In order for any of these actions to have been possible BCH, DCF and the Court had to be very clear in the shared view that Justina Pelletier’s symptoms were caused by psychiatric problems rather than medical ones – and a diagnosis of somatic symptom disorder just could not have given anyone that clarity.

    There’s something very shifty going on here when it comes to terminology – something that makes it possible for the new ruling to justify the Court’s decision to take the girl into custody, while at the same time justifying its reversal on the medical matter, putting her back in the hands of her medical team at Tufts. There’s a whole lot going on in that bit of slight of hand!

    • Justina’s case was brought to juvenile court as the ‘decision’ by the head of BCH’s Child Protective Team, Dr. Alice Newton. Dr. Newton is a “pediatric child abuse specialist”- ergo, “The Medical Expert”. This was not a complaint filed as a ‘typical’51-A for DCF to investigate, though many statements in the media, including those made by the PR manager at BCH, have passed the buck to DCF. (*note:DCF has virtually no medical expert oversight!). Dr. Alice Newton petitioned for the “protection of Justina Pelletier from Medical Child Abuse”. Protection deemed necessary last February was clearly spelled out as : Barring Dr. Korson and his colleagues from treating Justina, and revoking her parents’ right to make medical decisions. The severe restrictions placed on the Pelletier family’s contact with Justina began when she was admitted to Bader 5– 2 months after DCF gained custody. Clearly this violation of federal law was based on the determination by BCH psychiatric clinicians that Justina required protection from her parents because they had not accepted the new treatment plan that focused on psychological problems- THEY determined to be the major cause of Justina’s presenting symptoms. Again, these were actions that accord with “Medical Child Abuse” treatment.

      It is also likely that since Justina was not directly admitted to Tufts, by Dr. Korson = where he has admitting privileges, and since she was not accepted as a transfer by Tufts on February 14th, when Lou Pelletier opted to demand his daughter be discharged from BCH, “against medical advice”– ; there is reason to wonder if psychiatry at Tufts offered support of the need for psychiatric treatment of Justina. Tufts Floating Hospital for Children does not have an inpatient psychiatric unit. Only the Judge and DCF have seen the documentation from medical and psychiatric experts that informed the court’s ruling in every hearing since February 15th 2013. Since this information is protected by federal law, the public engages in both debate and protest without benefit of knowing exactly how the deck was stacked against the Pelletier family. I suggest that it may be more heavily stacked than current media is publicizing.

      I would like to take the discussion to the next level, since Dr. Hickey has so eloquently exposed the absurdity of employing the SSD diagnosis as a means for forcing anyone to undergo what amounts to a shot in the dark, as there is no scientific evidence to support psychiatry’s lame claim to “treatment” for their made up disorders! The next level is a discussion of what any psychiatric clinician does–or SHOULD know.

      It is not likely that a therapeutic alliance will be developed with an adolescent after ‘traumatically’ removing her parents, family, friends, community from her life. Important to remember that Justina was amongst total strangers at BCH. She traveled more than two hours from her home in West Hartford CT to Boston via ambulance 4 days before she saw security escort her parents off the unit where she remained– with total strangers. Regardless of whose ‘medical expert’ opinion informs a diagnosis for this teen, those who ripped her away from HER sense of safety and comfort would have an ice cube’s chance in hell of gaining her trust for ANY sort of treatment– regardless of the diagnosis.

      Laying claim to superior “medical knowledge”, these psychiatrists are way out of their league– and should be sternly rebuked by the REAL physicians at BCH. However, claiming intentions to “treat Justina for severe psychological problems, caused by her parents”, psychiatric clinicians at BCH show their incompetence- even to their own colleagues in the mental health field, as they begin their “treatment” by traumatizing their patient! AND their own judgment is called into question when they attribute Justina’s anxiety and regressed emotional responses to “their diagnosis”, while totally discounting the trauma reactive behavior expected from their own actions against her parents!

      While it may be the case that BCH operated within the bounds of ‘the laws’ that protect children from abuse, it has to be noted that their own actions only attest to the gross unprofessionalism of their department of psychiatry, known for its failure to acknowledge basic human nature and for complete disregard for parents.

      I hope the medical community at BCH will step up to the plate, as the true pediatric medical experts of this world renowned children’s hospital and lead the charge to revoke medical specialty status from psychiatrists. This is long overdue.

      It is due to the courage and tenacity of Justina and her family that we have a window of opportunity opening through which we can share crucial information that the public is literally demanding!

      • Sinead,

        Thanks for coming in. Your point about the therapeutic alliance is compelling – or at least ought to be. Unfortunately, however, there is an increasing tendency in psychiatry to ignore such matters, and simply dish out the pills and the electric shocks with or without the individual’s consent.

        Your call to the real doctors at BCH to speak out resonates strongly with me. I have always been puzzled by the fact that general medicine hasn’t taken a stand against the nonsense of psychiatry. Maybe Justina’s plight will provide some motivation in that regard.

        Best wishes.

        • Philip , Your articles always bring clarity,

          “I have always been puzzled by the fact that general medicine hasn’t taken a stand against the nonsense of psychiatry.”

          ” There have been since the times of Pasteur certain members of the AMA that have understood that foundational bedrock assumptions( for example their own revered interpretation of the germ theory) taken for granted to this day within general medicine can easily be proven to be false using real science in any laboratory that has a even a 30,000 magnification microscope .
          Another way to say it is they have their own nonsense for profit skeletons in the closet they must keep hidden .These have cost 10′s of millions of lives if not 100′s of millions of lives probably more, not even to speak of unmeasurable unnecessary suffering they have caused by suppressing truth for financial gain.
          For starters I strongly recommend Robert Young’s book ” Sick and Tired”.
          Sincerely, Fred

          • That’s true. Proving a medical error or negligence in courts borders on impossible and the more undefined the diagnosis is the easier is to hide mistreatment. It may not be so hard to prove that a surgeon cut out the wrong organ but to prove that the psychiatrist made a mistake – good luck to you. The only chances are that they are to lazy and stupid to fix the documents in time, else they can get away with actual murder. Unless they get caught raping a restrained unconscious patient on camera any kind of abuse goes. And the sad truth is that doctors cover for each other because they want someone to cover for them when they make a mistake.

        • Philip,

          My point regarding the therapeutic alliance reflects just one more aspect of the actions of psychiatrists that demonstrate a wide divergence from ‘medical model’ thinking. Removing Justina from her parent’s custody via a rambo style intervention underscores the severity of their treatment plan. Yet, apparently this drastic, trauma inducing intervention was not subjected to a simple risk v. benefit analysis, which medical practitioners employ routinely.

          The risk of traumatizing a teen who was already compromised, coping with a hospitalization in a setting completely unknown to her, was a blatant risk that would yield two potentially insurmountable obstacles:

          1) Justina would fear her new caregivers and definitely NOT trust them.

          2) Her reaction to this traumatic event would definitely appear as a new range of behaviors that completely distort any valid assessment of her emotional, mental status.

          Adhering to their own version of “medical model” reasoning, these psychiatry clinicians merely plugged in Justina’s trauma reactive behavior to the equation they had chosen as her diagnosis , evaluated her regressed emotional state and decreased functioning and then attributed their findings to, “the sick role” her parents had encouraged or caused her to assume.

          Then, the treatment became more focused on further restricting her parents contact with her and employing a behavior mod plan in the context of psychotherapy that targeted her regressed behavior.

          At no point did any of these psychiatric clinicians realize that the ‘ psychiatric disorder’ they were treating was an iatrogenic condition that they had inflicted!

          At no point was there any reason to believe that Justina would respond to inpatient psychiatric treatment that completely separated her from her family, friends and community.

          The so-called treatment plan increased Justina’s duress and simultaneously removed her safety net.

          Such is the treatment for “medical child abuse”– yet, the illegal imprisonment on a locked psychiatric unit and the clear indications that psychiatric clinicians inflicted harm to Justina SHOULD be grounds for criminal action for THEIR ostensible “medical child abuse”.

          According to the bible on MCA, criminal charges against *parents* are rare occurrences– yet this case definitely demonstrates the criminality of the actions of the psychiatrists who claimed to be rescuing a teen from medical child abuse– unneeded and harmful medical care initiated by parents ???No. inappropriate, harmful interventions initiated by psychiatry.

          Not a hint of an indication that the requisite therapeutic alliance with the patient was a consideration. Not a single reason to absolve these psychiatric clinicians for failing to recognize the trauma reaction that resulted from their *therapeutic intervention*.

          Psychiatrist’s enjoy a lofty status as MDs– I think it is time to introduce them to the principles and standards that Medical Doctors employ to abate potential harm to their patients.

          • There is no need for a therapeutic alliance since they view themselves as the absolute experts over other peopoles’ lives. At one time you could have said that there was at least some element of the theapeutic in psychiatry; psychiatrists had to go through psychoanalysis before they could get their liscense. Most of them at least knew the basics of talk therapy, whether they did it well or not is another question. This took time and expertise and you had to actually believe that the “patient” had something of value to add to their treatment by telling their story. You had to see them as human beings. Many psychiatrists did their own “work” and were familiar with their own issues; and willingly admitted that they were as “wounded” as the people they were helping. This helped them to be real healers.

            This is all part of the past. The only educaiton that a doctor going into psychiatry gets is all the stupid theories about the toxic drugs. They are not taught how to do talk therapy nor do they go into therapy themselves to see what they need to work on in their own lives. It’s the rare psychiatrist coming out of med school now who actually pursues education for herself/himself in the field of any kind of talk therapy. After all, they don’t need to know how to create a therapeutic alliance or do talk therapy since this is all just a matter of chemical imbalances and broken brains or faulty genetics. They have the “meds” to take care of everything. And, after all, they are the almighty “experts” about everything in everyone’s lives.

            With the advent of the drugs any thing of therapeutic value went right out the window. As the experts they know exactly what we need and by golly we’re going to get it whether we want it or not. After all, they’re doing all of this to us “for our own good, of course!”

          • “Yet, apparently this drastic, trauma inducing intervention was not subjected to a simple risk v. benefit analysis, which medical practitioners employ routinely. (…) Her reaction to this traumatic event would definitely appear as a new range of behaviors that completely distort any valid assessment of her emotional, mental status.”
            Isn’t that a systematic failure of the coercive psychiatry as a whole? Basically anyone who undergoes involuntary hospitalization with any of the range of “treatments” that go with it is likely to react with aggression, distrust, opposition, depression, and so on and so forth. Have you even heard a psychiatrist admit that any of these behaviours may not be a symptom of underlying illness but a simple reaction to violence? Even if these “symptoms” only occurred after the coercion was used? Same goes with drugs and their awesome ability to “unmask” other conditions. This failure of thinking is so inherent to psychiatric “treatment” that you won’t easily find a psychiatrist who will admit that it is even a possibility. And since psychiatrists are necessarily experts on the case, well, the case is lost from this perspective. Until the system is changed you can never prove that a psychiatrist made a medical error, since there is no objective way of proving that and the next psychiatrist is going to say it was all legit since he does the same thing in his practice.

          • Just one more note to Stephen Gilbert:
            I actually knew the psychiatrists who were also licenced psychotherapists. They were no better, maybe only that they waited slightly more before giving you a pill or tying you to the bed for speaking up to them. The point is: they don’t take you seriously. Even f it looks like they’re listening to you: they don’t. If you interpret an event in a way they don’t like they will force their interpretation on you. They assume they know you better that you know yourself, they are arrogant, they have a small range of unfounded theories of how the mind works (psychological theories are even more unfounded in any real evidence than the bio-psychiatry) and if it sounds like bullshit to you then again: you have no insight, or you have repressed this or that. Psychotherapy done by a stupid person on a gullible person can be extremely harmful. There were cases when people were turned against their families because the psychologist persuaded them that they had been sexually abused etc. by uncovering “repressed memories” that never really existed. I had one guy trying that trick on me: he wanted me to believe that I had bad parents. I went out of there in a second when I realised he’s not listening to me and pushing his bs on me, but a lot of people have less awareness. Persuasion can make innocent people admit to murder and going to a psychologist who’s malicious or stupid is dangerous. Personally, I don’t know a single psychiatrist whom I’d trust and only one psychologist I believe has the knowledge and ability to do her job.

          • Stephen,

            I was not referring to psychiatric treatment in a general sense, but pointing to specifics in the case of Justina Pelletier, where separating her from her parents and asserting “medical child abuse” as the validation for this over the top severe intervention, has created a golden opportunity to assess ‘psychiatry’ via medical model process.

            The time is at hand when we can expect to see a lifting of the veil of secrecy that has allowed psychiatry to justify itself to itself. Accountability where medical diagnosis and treatment, or in this case, the with holding of medical treatment, is pushing psychiatry into the arena where their psychobabble will not be tolerated.

            My post was a walk through of the very simple formula that exposes the weakness of even the most powerful psychiatrist– You may recall that metabolic specialist, Dr. Mark Korson’s email to the Pelletier’s attorney referred to the removing of Justina from the custody of her parents as a “extreme intervention” that was based on a “hunch”.

            It is fortunate that this case has become nationally reported and that many medical and psychiatric professionals are scrutinizing it. The responsibilities and duties to protect patients are universally applied to all subspecialties of medicine. It is about time psychiatry was reviewed via this template. There is no doubt that “it” will prove sorely lacking.

      • You’re right. If that happened to me I’d refuse to cooperate with them whatsoever and would go on a hunger strike active immediately. I don’t think that “treatment” of anyone against their will makes any sense unless you decide that this treatment equals forced drugging. Any kind of psychological intervention will be likely undermined.

      • I just want to add that the refusal of psychiatrists to admit that any of their actions and prescribed treatments, even involving procedures which are clearly described as torture by UN (physical restraint, seclusion, forced drugging, force feeding) can cause trauma and worsening or creation of new symptoms. Good luck trying to find a “professional” who would testify in court that any of these measures could cause PTSD or other trauma related “disorder”. Here are your options:
        If you listen to them and get better they take all the credit
        If you listen to them and get worse it’s not their fault
        If you don’t listen to them and get better they’ll ignore you or deny you’re better If you don’t get better after escaping the system with a trauma: see, they were right all along and god forbid you’re problems have anything to do with psychiatric abuse
        Good luck fighting this system with this logic. Even the supposedly better psychiatrists have this mentality – they can do no wrong.

        • I will have to agree with you here. Even the “good” psychiatrists have this mentality. Trying to dialogue with the “good” psychiatrists has gotten me nowhere in my place of employment. Once you come to the issues of their tosic drugs damagaing people over the long term they clam up and no longer have time to talk with you. As long as you’re a good “disciple” they’re more than willing to talk but just raise the thorny issues and see what happens.

          • I did – I asked the guy what he things of physical restraint and forced drugging etc. and he defended it all along and refused to admit that it could ever be abused. And then kicked me out of the room because he was not interested in discussing it. That was the “good” one.

      • Concerning the real doctors at BCH or any hospital coming down on the Dept of Psychiatry: An example where real doctors along with hospital medical support personnel are actually complicit, would be ECT. Anesthiology has been employed for decades to assist the psychiatrist, who stands to the side and pushes his button. The pt. is then wheeled to recovery room. Although I doubt that ECT is part of BCH’s offered services, the point is that there are areas of cooperation and coexistence. There may be private grumblings among medical staff, but no one is going to challenge Alice Newton and her team of child protection experts. I reread the Globe 2 part series and it mentions that Child protection is now a “certified area”. As Lou points out, the Docs are employees of the hospital.
        Your comments made me wonder about intersecting areas and the MCA textbook.

    • Diane,

      You’re correct. Under DSM-IV (i.e. until May 2013), the presence of a real illness effectively precluded the possibility of a psychiatric diagnosis. DSM-5 (May 2013) removed that safeguard. The APA justified this move on the grounds that even people with real illnesses might be overly (in their opinion) concerned about their symptoms and would therefore benefit from psychiatric “care.” But in fact it was just more of the same psychiatric expansion that we’ve been seeing for the past five decades.

      • On the positive side: I think that they’re getting more backlash now than ever. With 25-50% of the population being “mentally ill” they’re becoming more and more a cross between a mad psychiatrist from an old horror movie and a laughing stock. One just needs to channel this attitudes towards actual policies but I think the momentum is building and paradoxically the fact that it now affects almost everyone works to our advantage. It’s not anymore just a bunch of crazy schizophrenics running around with knives who don’t want to take their meds because they’re too crazy, it’s everyone.

  4. I would suggest that a volunteer squad of Iraq and/or Afghanistan war veterans could go in and free Justina and return her once again to her parents but the Psychiatric gestapo has them as well drugged to the gills .There was an underground railroad to free oppressed people in civil war times it looks to me like theres a pressing need in this very hour.

  5. One diagnosis we’ve been spared from the DSM-5— a lot of psychiatrists noticed a lot of what they called “excessive bitterness” after the global financial crisis. I can’t imagine what treatment they would have recommended for the “excessive” bitterness of people who had lost their homes and/or a huge chunk of their retirement savings and/or their jobs because of our scheming financial overlords.

    • Wileywitch,

      An interesting thought, but sadly not accurate. Here is a short list of the range of “diagnoses” available for these individuals: major depressive disorder; other specified depressive disorder; generalized anxiety disorder; other specified anxiety disorder; adjustment disorder; other specified trauma-&-stressor-related disorder; etc… In addition, if the individual reacts to his/her losses in a way that a psychiatrist considers extreme, the door is opened to virtually any DSM item.

      One of the great problems with psychiatry and the DSM is that it routinely conceptualizes systemic social and political problems as residing in the individual (in the form of mental illnesses) and effectively serves to dilute and even neutralize efforts to reform.

      Best wishes.

      • It’s funny how the “mental illness” correlates with socioeconomic factors such as poverty and goes up in times of recession but in the same time it’s completely a biological in origin.

  6. I agree with everything you write Philip, but I have one reservation.

    Sometimes people do imagine or create illnesses in themselves and their children. I know a woman whose partner convinced her that she and her two daughters had ME. The daughters were not allowed out and had to stay in bed for most of the day. My friend called the police when the man tried to sexually assault her daughters. The man was arrested, tried and found guilty of several things including successfully convincing these people that the children were ill when they were not. He had done this with several adult women as well as these this woman and her children. He ran a kind of mini therapy cult where he convinced women that they were ill and that he could cure them by a kind of primal therapy.

    So factitious illness does exist and it does need dealing with. However I do not think it needs to be a medical matter. A Dr could testify that they cannot find a medical condition, or two Dr’s could disagree. The case could then be passed to social care professionals for further investigation.

    On another point, many might think that psychiatry diseases are factitious illnesses and that psychiatry is a cult where damaging so called treatments are handed out and where the staff benefit while so called patients are usually harmed. However that is another point.

    • John, I appreciate your concern for children who suffer from these kinds of tendencies in parents, but there’s immense danger in your approach. It rests on a faith in medical diagnostic practice that’s just impossible to support.

      Equating lack of medical diagnosis with presence of mental health diagnosis is common but it’s indefensible – I mean, there exists no evidence of any kind to support the view that unexplained physical symptoms generally have mental health causes.

      There are, for example, as many patients with rare diseases as patients caught up in the “epidemic” of diabetes – that’s 1 in 10 Americans. Because there are 7000 rare diseases, no doctor can be familiar with even a significant portion of them. That means doctors see 2-3 patients every single day with diseases they’re just not likely to recognize without pursuing the unknown. These numbers tell us it’s straightforwardly unethical to suppose that what a doctor has been unable to explain must be a mental health problem.

      Here’s a figure that helps put the proportions of these problems in focus. Justina Pelletier’s diagnosis of mitochondrial disorder was overturned when her parents were charged with medical child abuse. How common are these two disorders? According to studies, mitochondrial disorder is 40 times more common than medical child abuse (1/5000 vs 1/200,000). Presuming rare disease in children is less likely than psych problems in parents is a statistical error of colossal proportions. In the case of mito it’s mistaken 40 times over.

    • Well, but that’s a different story: seems like this guy did not believe that his kid actually had an illness or that any doctor has even seen them: basically he was a scam artist/cult leader. There are some scary psychopaths out there as well but that does not happen very often and it’s usually very transparent even to a lay person when the case is investigated. If there is sexual and physical abuse, that’s not a psychiatric diagnosis, that’s jail time.
      I find it preposterous how nowadays the line between crime and mental illness gets blurred. Not only are the “mentally ill” being associated with violence but also almost every criminal can get a psychiatric label. Even a psychopath is essentially a medical diagnosis. For me it should be clear:
      if one can prove insanity led to a crime (like clear case of hallucinations and detachment from reality during a psychotic episode) then it’s an indication to treatment not conviction
      if one was not completely detached from reality but acted in strong emotional stress (covers all anxieties, depressions, bipolars and such) – one can assess the case and the severity of crime and circumstances and serve a reduced sentence with proper rehabilitation and psychological intervention in prison
      if someone has a “personality disorder” or other “mental illness” that does not lead to hallucinations or high emotional states: well that’s prison time, sorry
      No diagnosis needed: all you have to do is to assess evidence if the person was in touch with reality at the time of the crime, what was his or her emotional state and what factors influence it and if the crime was planned etc. No need to go into DSM crazy land. Right now even having a certain type of character is a mental illness.
      What is the most outrageous about trying to explain every antisocial behaviour in terms of mental illness is that it stigmatise completely non-violent people who happen to have that label stuck all over their heads and justifies all the coercive policies. So if there was one psycho somewhere who locked up his daughter and raped her that means you can take a child from Pelletiers.

      • I do no think creating fake diseases in others, including children, is a psychiatric problem. I did not say that. I said that if no medical condition is in evidence and a Dr or someone suspects something fishy is going on it needs investigating. However this means a fair process needs to be in place. What happened in this case is not fair process. That is one of the problems here.

        There was no open court proceedings, the family were not allowed to present evidence with their own experts allowed to speak. It was an entirely biased procedure.

        • I appreciate the clarification. I’m an ethicist who runs a nonprofit to advocate for patients mistakenly denied medical care because of reckless diagnosis of somatoform disorder (or something like it). This problem is an epidemic of staggering proportions, and it’s what created the Pelletier case.

          How about instead of setting up courts to make these decisions, doctors just respect the rights of patients (and parents) in cases of somatoform diagnosis, so patients (and parents) just continue to make their own autonomous decisions? If everyone respects patients’ rights from the start these kinds of cases cannot occur.

          • When “child abuse” is at issue, the accused parents/caregivers lose rights to make medical decisions and to provide direct care to their children. Very important matter in Justina’s case.

            Also- per Dr. Thoma Roesler’s book “Medical Child Abuse. Beyond Munchausen’s by Proxy “– “Child protection workers, judges and police- by necessity defer to medical people when MCA is considered” (pg. 95)

            It is the “pediatric child abuse specialist” who is considered the “Medical Expert” to whom the judge and DCF defers– even the police who responded to Lou Pelletier’s 911 call; “BCH is about to kidnap my daughter”; noted that the police deferred to the ‘medical people’ on the neurology floor where Lou was eventually ‘removed’ by hospital security escort.

            It is common misunderstanding– based on the parents being the main source of media info, that there was a diagnosis dispute and somatoform was accepted over Mito. The actions of Dr. Newton indicate a cause for suspecting harmful medical procedures were at issue– not the actual diagnosis.

            More likely the extensive and quite rare surgical procedure “cecostomy” was cited as the “harm done” to Justina by “her doctors”. The question of neuopathy of the colon v. psychosomatic illness — or how much dysfunction is related to the diagnosis of Mito — aligns with a Soamtic Symptoms Disorder diagnosis’ which clearly does not discount medical diagnosis.

            It is hard for some people to move away from advocacy for “patient/parents” rights– seems like a good platform from which to wage a battle., no doubt. However, there were actually no “rights”violations in Justina’s case– Adhering strictly to the laws that protect children from abuse– BCH reported MCA and then protected Justina–. from further MCA.

            The fact that the abuse was cited as ‘medical’ automatically put the medical experts at BCH in the drivers seat–meaning that the judge and DCF would defer to BCH. And this bore out through to the final court ruling.

            We won’t see what was documented medically/psychiatrically to inform the judge’s ruling. The details of the case for medical child abuse are protected by federal law– and not subject to ‘public debate”– ergo: the perfect crime–

          • I run out of reply threads but I want to address this to Sinead:
            I understand what you’re writing but that still makes no sense. It does not matter if the psychiatrists at BCH though that the medical abuse was the diagnosis itself or the following treatment: the whole process was not some random action by the parents themselves: it was conceived, approved and performed by certified medical professionals in another hospital. So logically speaking the BCH should accuse Tufts doctors of medical error or something like that and not the parents who are not experts and by definition follow the doctors advice. So if there is any question of abuse then it should be doctors at another hospital who are guilty and not the parents whose only guilt seems to be that they followed the wrong kind of medical advice. that is absolutely crazy that the parents became targets of this whole thing when the dispute should be settled by medical community and if they can’t come to coherent conclusion then the parents should have the right to decide which doctor to trust. How that translates into Pelletries abusing their daughter???

  7. What can we do? The Pelletier case illustrates how vigilant we must be to confidently raise our kids and calmly challenge the prevailing ADHD/ODD/Mood disorder culture. Make sure you have a sure footed pediatrician who has a healthy skepticism of child psychiatry. I have a network of friends and relatives who now look at the issue in a different way. Stay out of the swamp of left right politics and look at the huge area of common ground. Support and raise awareness of those trying to detox from psych drugs. I might be in favor of NIMH backing research in the detox process.

  8. I don’t believe the NIMI would back anything that had the slightest chance of interfering with psych-pharma-medico cash flow . If you want to see the best research on the detox process so anyone can make a plan to customize their own put After Serquel in the search box right here at MIA and see Nancy’s must read most informative article and comments on the subject. Also do a study within Traditional Naturopathy on Elimination and Purification and see how that fits. Homeopathy also helpful during detox. Also YuenMethod as one energy healing system that would be very helpful . Also check Paracelsus Klinic and research what they do there. There would be some variation with each individual.

  9. Thank you for keeping us informed of this case Dr Hickey.

    I find it interesting that this exposes the farce that is psychiatry. It also shows quite clearly how the arena of the court’s can be used to pervert the course of justice. Simply have fabrication accepted as facts.

    No only are psychiatrists making a mockery of science, but they are also making an absolute joke of our justice systems. Who is the real danger to self or other here?

  10. As a professional advocate working in the child welfare system, I can say that in Oregon, the standard is not that the child may or may not have a particular disorder, but that his/her physical safety is directly and immediately endangered. A parent could believe that Martians are outside the home looking in the windows, and have convinced the child that this is true, but if the child is able to eat, sleep, attend school, and is otherwise safe and healthy, having a shared delusion is not grounds for CPS to intervene (though they might well attempt to). Any parent has a right to seek out medical care for his/her child, and make medical decisions based on informed consent, without any interference from the government, unless the child is in immediate danger. The question should not be “does this child have ‘Somatic Symptom Disorder’ (gags me even to write that down!), but whether she is in immediate danger from her parents. Which she obviously is not. So WTF, Massachusetts? I hope they appeal this to the Supreme Court of Mass, and if necessary, of the US. There are some fundamental liberty rights being freely trampled here, and some judge somewhere is going to call them on this crap. And then I hope they sue the pants off of MGH and the State of Massachusetts.

    — Steve

  11. Steve,
    Which one of our courts would over rule the findings and recommendations of a board certified pediatric – child abuse specialist? I think that judges aren’t considered medical experts and the only case where a judge/jury would/could nullify the findings and recommendations of the the child abuse specialist in a case of MCA — would be a civil suit where ‘other medical experts’ could weigh in.

    I wonder who those experts would be– considering that the medical experts from Tufts, in
    Justina’s case have been quiet and passive regarding their patient being literally hijacked from their care. I mean, even her own top notch medical guys have avoided going head to head w/ Dr. Alice Newton.

    The acceptance of both MCA and SSD is at the root of this and other tragic scenarios– it is not a Massachusetts or even a BCH creation !!!

    Think it is an example of ‘collusion’– not a “medical collision with a child caught in the middle”–

    Psychiatry departments from two leading hospitals, overturning the medical management of a teen– by citing top ranked pediatric specialists as the ‘pawns’ of abusive parents–.

    Dr. Roesler, who wrote the play book for this coup is originally from Washington State. He established his treatment center for MCA at Hasbro Children’s Hospital in Rhode Island, before heading back to Seattle.

    I guess we haven’t seen enough evidence of the fruitlessness of law suits ??

  12. The silence of her previous doctors is really astounding. I don’t know what are the real reasons for it but it makes the whole story even more fishy.

    • Dr. A;lice Newton granted an interview to Neil Swidey of the Boston Globe and she appeared in the video produced by Scott LaPierre of the Globe. Her statements clearly reflect the arrogant logic of Dr. Thomas Roessler, who absolves the physicians who performed “unneeded, harmful- or potentially harmful medical care”.

      “We think that doctors could not,because of their sense of guilt and shame, bring themselves to admit their complicity, and acknowledge that their benevolently applied treatments were making children ill. Doctors and nurses are blind to the abuse because they are involved and want, more than anything, not to have to look at the abuse.” (Medical Child Abuse..pg 95.)

      Dr. Newton provides a glimpse of her confirmation bias in judging parents who have violated the patient/doctor relationship by giving the doctor false information and by over dramatizing the child’s symptoms. The blaming of parents for the illnesses of children is deeply engrained in the thinking of most child psychiatrists. Dr. Newton expresses pity and compassion for the ‘pediatric medical specialists’ who are NOT trained to look for the obvious. Hard to imagine REAL doctors putting up with psychoanalysis by proxy– even if it is cloaked in protecting them from being cited as the “abusers”.

      Dr Mark Korson was interviewed for the 2 part Boston Globe article, explaining in detail the argument he waged when Dr. Newton informed him of BCH’s intention to accuse the Pelletier’s of instigating unneeded and harmful medical care for Justina. It is clear that Dr.
      Korson was not being sought to explain or defend the medical/surgical procedures Justina had received from his colleagues at Tufts; clear that Dr. Newton did not contact Dr. Korson to engage in a diagnosis “dispute”. It remains a mystery why Dr. Korson did not send the Pelletiers to Tufts in the first place. Maybe psychiatry at Tufts presented a risk to his authority to continue to provide medical interventions for Justina ? Maybe he simply hoped that his former colleague , Dr. Flores, the GI sepcialist, would take over– though it remains unclear why Dr. Korson did not know that he could not initiate a ‘direct admission’ to a specialist in a hospital in which he did not have admitting privileges.

      The ‘silence’ of the doctors described by the Pelletiers as “the BEST”; the ones who were successfully treating Justina looks like a resignation to the power of psychiatry– possibly in both Tufts and Boston Children’s Hospital.

      The testimony given by Justina’s doctors was heard by the judge who also had documentation by the ‘expert’ in pediatric child abuse, and documentation from medical records at BCH that are not going to be made public. Judge Johnston deferred to the child abuse expert, who had demonstrated no malice towards these doctors– only pity and compassion for their plight.

      Meanwhile DCF reports regularly to the court that the Pelletiers adamantly refuse to accept that their daughter is in need of extensive psychiatric treatment. Any support of their views on Justina’s condition or needs for medical care are filtered through the profile of ‘parents who use the medical profession’ to abuse their children. As Dr. Roessler and Alice Newton point out– these parents shop for doctors who agree with them and garner support through dramatic behavior around the seriousness of their child’s illness.

      At the root of this, we have broad sweeping generalizations that come form a child psychiatrist with 30 years of practice under his belt, who worked tirelessly with a group of like minded pediatric mental health clinicians to absolve them all from the arduous task of diagnosing and treating “Munchausen’s by Proxy”. The first few chapters of Dr. Roesler’s book are devoted to the brainstorming that went into “going beyond this diagnosis”, under the pretext of having the requisite authority to save the children from MCA.

      MCA was accepted by the American Academy of Pediatrics , who also established pediatric child abuse as a subspecialty of pediatric medicine. It is absurd to think that a juvenile court judge is going to over rule the authority of these board certified pediatric specialists. Just as it is naive to assume that these cases are going to become simple matters of patient/parent’s rights violations.

      Media coverage of one side of the story around Justina’s case has only created public outrage towards the wrong targets. This case is not an example of government over reach into the personal rights of parents. The ‘government’ /State has had this power for well over one hundred years. This case is about psychiatry’s ever expanding over reach.

      I suggest we put psychiatry in the spot light and carefully examine, fully expose the extent to which psychiatrist’s have caused harm via their lacking in medical knowledge and their cavalier dismissal of evidence based medicine.

      BCH is suffering damages to their reputation that could affect their ability to retain some of the BEST pediatric specialists in the country, although the right winged media spokespeople for the Pelletiers are saying their goal is to both defund and bankrupt this Harvard teaching children’s hospital by encouraging a boycott of BCH. The sad reality here is that it is really only children in need of specialized medical care who will suffer.

      Public outrage at this new power play by psychiatry might help BCH physicians to confront the hospital administration and demand disciplinary action against the few who were allowed to create this nightmare–. Otherwise, it is most likely many will simply resign and move on –.

      This is a great opportunity for the writers and readers on this site to create a public debate on the issues we fully understand to be a danger to the public– We could prevent this scourge, thwart another assault against our children by HMS child psychiatrists. Or rather, the true mark of an educated person is his/her ability to take valuable lessons from history and prevent repetition. Protecting children from psychiatric abuse — a form of ‘medical child abuse’ for which WE are the experts, is the task at hand.

  13. Let’s say that Justina really is too overly preoccupied with her physical sensations. If that were true, what would be a good way to help her with that? Lock her in a psych ward for a year, with no education and only minimal medical care?

    Just making sure she has support people other than her parents, to talk to about what she is going through medically, would probably do the trick. (At 15, teens do need support people outside of the family.) Even if you were to believe them that Justina is over-focused on symptoms, the rest of their behavior is still really ludicrous.

    Or, let’s say that the parents really are over-exaggerating Justina’s problems. Justina is 15 years old. She can talk. The doctor could simply talk with Justina and make sure to get her view, separately from her parents. I had a serious injury when I was 15- the doctor talked with ME, not my parents, about it, to get information. They can also do tests to detect the physical problems. The parents could then be offered counseling and perhaps a support group of other parents of children with rare conditions, to help them relax about their child’s condition.

    Clearly, these are caring, well intentioned parents, dealing with a scary and little-known medical condition of their daughter, and this is a teenager going through a scary and little-known medical condition. Some support for all, with that in mind, is what a competent, ethical medical professional would pursue, if in fact the dynamics are what are being portrayed by BCH.

    BCH’s and DCF’s behavior is absurd, even if you agree with their assessment of the situation. Perhaps they are the ones who are abusing by proxy, and the whole thing is a projection? Perhaps this is systematic, with lots of kids?

    • “Perhaps this is systematic, with lots of kids?”
      I’ve heard somewhere (I think it was one of the interviews with Justina’s sister) that there were parents of other kids who had these kind of problems with BCH. It was just mentioned and there is no way to know unless these families come out but it may be a bigger issue. Also, apart from psychiatry there seems to be an issue with kids taken away by child protective services and put in foster care based or some minor infractions on the part of the parents or even obvious mistakes.

  14. Also: Regressed behavior is a normal, almost universal, phenomenon in traumatized kids. They especially do it around people they feel safe with.
    If she is displaying regressed behavior, the most likely reason is she has been traumatized. (By BCH?) And she would mostly do it around people she feels safe with. The parents don’t “cause” it. They are people she feels safe with.
    This isn’t rocket science. Anyone with a basic understanding of trauma in kids, would know this.

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